Introduction/Background PIPAC is an emerging technique of administering intraperitoneal chemotherapy. The benefits of this method include improved drug distribution and tissue target thus becoming a potential new treatment available for patients with peritoneal metastases. To our knowledge, this is the most rigorous review of the current evidence on safety and efficacy of PIPAC specifically in patients with ovarian (OC), fallopian tube (FTC) and primary peritoneal (PPC) carcinomas with peritoneal metastases.

Methodology The present review was registered with PROSPERO and conducted in accordance to the PRISMA checklist. Terms related to the use of PIPAC in management of all cancers were searched in MEDLINE (Ovid), EMBASE (Ovid) electronic databases and Cochrane Library. Screening and study selection were performed by all authors.

Results 9 studies reporting outcomes specific for patients with OC, FTC and PPC were identified and included in the analysis, comprising of 158 patients and 257 PIPAC procedures. 159 Grade 1, 41 Grade 2, 13 Grade 3 and 2 Grade 4 toxicity events were recorded out of 209 procedures. Rate of histological regression ranges from 62% after 1 procedure to 76% following 3 procedures. Overall quality of life score based on responses to the EORTC QLQ-C30 v3.0 questionnaire improved following treatment. Median survival ranges from 6.8 months after 1 treatment up to 22 months after 3 procedures.

Conclusion With acceptable levels of low-risk complications and low rate of morbidity and serious complications, the results of this review suggest PIPAC offers an alternative treatment option for management of advanced OC, FTC and PPC with peritoneal metastases.